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CPT®
44397

CPT® Code 44397
Deleted

Code deleted, see 44402

Official Description

Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A colonoscopy through stoma is a specialized procedure that involves the examination of the colon via an existing stoma, which is an opening created surgically to allow waste to exit the body. This procedure is particularly relevant for patients who have undergone colostomy or ileostomy surgeries. During this procedure, a colonoscope, which is a flexible tube equipped with a camera and light, is inserted through the stoma and advanced to the area of the colon that may be experiencing stricture or obstruction. The procedure includes the placement of a transendoscopic stent, which is a tube-like device used to keep the passage open, and this process also involves predilation, a technique used to widen the stricture before stent placement. The use of fluoroscopic guidance, which employs real-time imaging, is crucial for accurately navigating the stricture and ensuring the proper placement of the stent. This procedure is essential for alleviating symptoms associated with bowel obstructions and improving the quality of life for patients with colonic strictures.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The colonoscopy through stoma with transendoscopic stent placement is indicated for patients experiencing specific gastrointestinal conditions. These include:

  • Colonic Stricture - A narrowing of the colon that can lead to obstruction and requires intervention to restore normal bowel function.
  • Colonic Obstruction - A blockage in the colon that prevents the passage of stool, necessitating the placement of a stent to alleviate the obstruction.
  • Post-Surgical Complications - Issues arising from previous surgeries, such as colostomy or ileostomy, that may result in strictures or obstructions.

2. Procedure

The procedure for colonoscopy through stoma with transendoscopic stent placement involves several critical steps:

  • Step 1: Introduction of the Colonoscope - The procedure begins with the careful introduction of a colonoscope through the colostomy opening. The colonoscope is advanced through the stoma to reach the site of the stricture or obstruction within the colon.
  • Step 2: Fluoroscopic Guidance - Under fluoroscopic guidance, a biliary catheter is advanced over a guide wire through the identified stricture. This imaging technique allows for real-time visualization of the colon and the stricture, ensuring accurate placement of the catheter.
  • Step 3: Contrast Injection - Once the catheter is in place, contrast material is injected through it to assess the length and severity of the stricture. This step is crucial for determining the appropriate size of the stent needed for placement.
  • Step 4: Guide Wire Management - After the contrast injection, the guide wire is removed, and then reinserted to facilitate the next steps of the procedure.
  • Step 5: Balloon Catheter Placement - A balloon catheter is passed over the guide wire and positioned in the center of the stricture. The balloon is then inflated to dilate the stricture, which helps to prepare the site for stent placement.
  • Step 6: Stent Placement - Following the balloon dilation, an appropriately sized expandable stent is placed across the stricture. This stent is deployed under both endoscopic and fluoroscopic guidance to ensure correct positioning.
  • Step 7: Verification and Withdrawal - The correct position of the stent is verified endoscopically, ensuring that it is properly placed to maintain the patency of the colon. Finally, the colonoscope is withdrawn from the stoma.

3. Post-Procedure

After the completion of the colonoscopy through stoma with transendoscopic stent placement, patients may require monitoring for any immediate complications. Post-procedure care typically includes observation for signs of bleeding, infection, or stent migration. Patients may also be advised on dietary modifications and follow-up appointments to assess the effectiveness of the stent and the overall condition of the colon. It is essential for healthcare providers to provide clear instructions regarding any symptoms that should prompt immediate medical attention, such as severe abdominal pain or changes in bowel habits.
Short Descr COLONOSCOPY W/STENT
Medium Descr COLONOSCOPY STOMA W/TNDSC STENT PLMT
Long Descr Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special rules for multiple endoscopic procedures apply...
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 44388  Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8D - Endoscopy - colonoscopy
MUE Not applicable/unspecified.
CCS Clinical Classification 76 - Colonoscopy and biopsy
Date
Action
Notes
2015-01-01 Deleted Code deleted, see 44402
2001-01-01 Added First appearance in code book in 2001.
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